University Mental Health Institute of Montreal, University of Montreal, Montreal, Québec, Canada.
Clinical Pharmacology and Toxicology Program, Royal College of Physicians and Surgeons, McGill University, Montreal, Québec, Canada.
Psychother Psychosom. 2023;92(6):359-366. doi: 10.1159/000535113. Epub 2023 Dec 7.
The Extrapyramidal Symptom Rating Scale - Abbreviated (ESRS-A) is an abbreviated version of the Extrapyramidal Symptom Rating Scale (ESRS) with instructions, definitions, and a semi-structured interview that follows clinimetric concepts of measuring clinical symptoms. Similar to the ESRS, the ESRS-A was developed to assess four types of drug-induced movement disorders (DIMD): parkinsonism, akathisia, dystonia, and tardive dyskinesia (TD).
The present review of the literature provides the most relevant clinimetric properties displayed by the ESRS and ESRS-A in clinical studies. Comprehensive ESRS-A definitions, official scale, and basic instructions are provided. ESRS inter-rater reliability was evaluated in two pivotal studies and in multicenter international studies. Inter-rater reliability was high for assessing both antipsychotic-induced movement disorders and idiopathic Parkinson's disease. Guidelines were also established for inter-rater reliability and the rater certification processes. The ESRS showed good concurrent validity with 96% agreement between Abnormal Involuntary Movement Scale (AIMS) for TD-defined cases and ESRS-defined cases. Similarly, concurrent validity for ESRS-A total and subscores for parkinsonism, akathisia, dystonia, and dyskinesia ranged from good to very good. The ESRS was particularly sensitive for detecting DIMD-related movement differences following treatment with placebo, antipsychotics, and antiparkinsonian and antidyskinetic medications. ESRS measurement of drug-induced extrapyramidal symptoms was shown to discriminate extrapyramidal symptoms from psychiatric symptoms.
The ESRS and ESRS-A are valid clinimetric indices for measuring DIMD. They can be valuably implemented in clinical research, particularly in trials testing antipsychotic medications, and in clinics to detect the presence, severity, and response to treatment of movement disorders.
锥体外系症状评定量表-简明版（ESRS-A）是锥体外系症状评定量表（ESRS）的缩写版，附有说明、定义和半结构化访谈，遵循了评估临床症状的临床计量学概念。与 ESRS 类似，ESRS-A 旨在评估四种药物引起的运动障碍（DIMD）：帕金森病、静坐不能、肌张力障碍和迟发性运动障碍（TD）。
本文献综述提供了临床研究中 ESRS 和 ESRS-A 最相关的计量学特性。提供了全面的 ESRS-A 定义、官方量表和基本说明。在两项关键性研究和多中心国际研究中评估了 ESRS-A 的组内者间信度。评估抗精神病药引起的运动障碍和特发性帕金森病的组内者间信度均很高。还制定了组内者间信度和评定者认证流程的指南。ESRS 与 TD 定义病例的异常不自主运动量表（AIMS）之间具有良好的同时效度，两者的一致性为 96%。类似地，ESRS-A 的帕金森病、静坐不能、肌张力障碍和运动障碍总分和分量表的同时效度从良好到非常好。ESRS 特别敏感，能够检测出与安慰剂、抗精神病药以及抗帕金森病药和抗运动障碍药治疗相关的 DIMD 相关运动差异。ESRS 用于评估药物引起的锥体外系症状，可将锥体外系症状与精神症状区分开来。
ESRS 和 ESRS-A 是测量 DIMD 的有效计量学指标。它们可在临床研究中得到有价值的应用，特别是在测试抗精神病药物的试验中，以及在诊所中用于检测运动障碍的存在、严重程度和对治疗的反应。
